Provider Demographics
NPI:1285798579
Name:SMITH, LUCY A (RN MS CS APRN)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN MS CS APRN
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2420 HAMPDEN ROW
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23146-2137
Mailing Address - Country:US
Mailing Address - Phone:804-342-0993
Mailing Address - Fax:804-749-3480
Practice Address - Street 1:7603 FOREST AVE
Practice Address - Street 2:SUITE 209 HDH COURTYARD MEDICAL BUILDING
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4942
Practice Address - Country:US
Practice Address - Phone:804-342-0993
Practice Address - Fax:804-749-3480
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0001076110163W00000X
VA0015000033364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult